无菌体液分离病原菌菌种构成分布情况及耐药性变迁  

Distribution of pathogens isolated from sterile body fluids samples and changes in drug resistance

作　　者：吕宏培[1] 王远[1] 刘丽萍[2] 王优良[1] 曹明月 Lv Hongpei;Wang Yuan;Liu Liping;Wang Youliang;Cao Mingyue(Department of Clinical Laboratory,Daqing Longnan Hospital,Daqing,Heilongjiang 163000,China)

机构地区：[1]大庆龙南医院检验科,黑龙江大庆163000 [2]大庆龙南医院输血科,黑龙江大庆163000

出　　处：《齐齐哈尔医学院学报》2024年第12期1156-1166,共11页Journal of Qiqihar Medical University

基　　金：大庆市指导性科技计划项目(zdy-2023-24)。

摘　　要：目的了解2017—2023年本院无菌体液标本检出病原菌的分布及其耐药性变迁,为本地区医疗机构经验使用抗菌药物提供及时依据。方法选取2017—2023年本院无菌体液标本,排除同一患者重复株,使用WHONET 5.6软件对药物敏感性数据进行统计分析。结果共检出菌株6711株,其中革兰阴性杆菌3927株,革兰阳性球菌2530株,真菌145株,厌氧菌59株。分离病原菌前五位依次为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌。肠杆菌目细菌中,大肠埃希菌和阴沟肠杆菌对常用抗菌药物的耐药性较稳定,肺炎克雷伯菌对抗菌药物的耐药性明显升高。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类耐药率平均为1.2%和12.8%。铜绿假单胞菌对常用抗菌药物的耐药率较低且有降低趋势,鲍曼不动杆菌对常用抗菌药物的耐药率较高且稳定。甲氧西林耐药金黄色葡萄球菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)的检出率分别为31.2%和71.4%,两者对常用抗菌药物的耐药性较稳定,MRSA的检出率有一定程度的降低。屎肠球菌和粪肠球菌对万古霉素和利奈唑胺均保持高度活性,对常用抗菌药物的耐药性较稳定。结论2017—2023年本院无菌体液病原菌以革兰阴性杆菌为主。及时监测病原菌种类、分布和耐药情况以指导临床合理用药,可有效减缓细菌耐药性的产生。Objective To explore the distribution of pathogens that isolated from sterile body fluid samples and their drug resistance changes in the hospital from 2017 to 2023,and to provide real-time basis for the rational clinical application of antibiotics in the region.Methods Clinical sterile body fluid samples collected from patients hospitalized in the Daqing Longnan Hospital from 2017 to 2023 were enrolled in the study,and repetitive pathogens isolated from the same patient was excluded.WHONET 5.6 software was used to statistically analyze the drug sensitivity data.Results A total of 6,711 non-repetitive pathogens were isolated from sterile body fluid samples,of which 3,927 were Gram-negative bacteria,and 2,530 were Gram-positive bacteria,and 145 were fungal pathogens,and 99 were anaerobion.The five pathogens with the highest isolation rates were Escherichia coli,Coagulase-negative staphylococcus,Klebsiella pneumonia,Staphylococcus aureus and Pseudomonas aeruginosa.Escherichia coli and Enterobacter cloacae had stable resistance rates to common antibiotics,but the resistance rates of Klebsiella pneumonia to common antibiotics was obviously increased.Carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae were 1.2%and 12.8%,respectively.The resistance rate of Pseudomonas aeruginosa to common antibiotics was low and had a decreasing trend,while the resistance rate of Acinetobacter baumannii to common antibiotics was high and stable.The detection rates of Methicillin-resistant Staphylococcus aureus(MRSA)and Methicillin Resistant Coagulase Negative Staphylococci(MRCNS)were 31.2%and 71.4%,respectively,and they had stable resistance rates to common antibiotics.The detection rates of MRSA was gradually decreasing.Enterococcus faecium and Enterococcus faecalis maintained high activity to vancomycin and linezolid,and the resistance to common antibiotics was stable.Conclusions Gram-negative bacteria are the main pathogens of sterile body fluid samples from 2017 to 2023.The species,distribution and

关 键 词：无菌体液 病原菌 耐药性 耐药率变迁 

分 类 号：R978.1[医药卫生—药品]